Physicians may be able to practice medicine by virtue of having a state license, but a healthcare facility ultimately decides what specific privileges physicians will have based on verification of their education and training. Before a hospital grants a physician or medical staff member privileges, they examine the provider’s educational background. This complex and lengthy process is known as educational credentialing.
When applying for hospital privileges, physicians must provide copies of their education credentials, including their medical diploma, final medical school transcript, and transfer credit transcripts, if applicable. Education credentialing involves verifying the education and training information that medical staff provide to ensure legitimacy. Hospitals, group practices, credentialing verification organizations, health plans, and ambulatory care settings all conduct credentialing.
Credentialing is used to determine a practitioner’s competence and professional suitability to provide safe, high quality healthcare services within specific environments. Education credentialing ensures that patients receive care from providers who are appropriately educated and trained to perform specific services.
Primary source verification is the technique used to accomplish education credentialing. Through this process, an organization validates an applicant’s education, training, and other credentialing information with the organization that originally issued the credential to the provider. Typically, re-credentialing is conducted every three years to maintain current and accurate files. If a practitioner is found to no longer meet minimum credentialing requirements, his or her clinical privileges may be terminated.
In order to qualify for physician licensure by the Ohio Medical Board, a US-trained applicant must have graduated with an MD or DO degree from a medical school accredited by the Liaison Committee on Medical Education (LCME) or the American Osteopathic Association (AOA). Graduates of medical schools located in the US or Canada and accredited by the LCME or AOA must successfully complete one year of graduate medical education (GME) or its equivalent as determined by the Board.
Graduates of all other medical schools must hold a valid certificate from the Educational Commission for Foreign Medical Graduates (ECFMG), complete at least two years of GME or have completed a Fifth Pathway Program plus one year of GME or its equivalent. Regardless of citizenship or country of birth, foreign medical graduates must also achieve a score of at least 26 in Speaking and 26 in Listening with a total score of 90 on the TOEFL iBT. In order to be recognized as a Fifth Pathway Program graduate, an applicant must submit evidence to the Ohio Medical Board that he or she has done all of the following:
While the education credentialing process is intended to protect patients from doctors and other medical professionals who pose a danger to their health and safety, participants may abuse the process in order to drive out the competition. If you suspect that the credentialing process is being used to unfairly advance an organization’s political or economic motives and your hospital privileges are at risk of being denied or revoked, consult a seasoned healthcare attorney.
Jones Law Group in Columbus, Ohio has substantial experience representing healthcare professionals throughout the education credentialing process. To discuss your legal concerns with one of our knowledgeable attorneys in a free initial consultation, please call (614) 545-9998 or contact us online.
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